Latest / Connect Call / EP17 - Exploring the Future of Treatment: Psychedelic Medicine with Jonathan Lowe

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EP17 - Exploring the Future of Treatment: Psychedelic Medicine with Jonathan Lowe · Connect Call

• 0:00
  [SPEAKER_00]: Hi, you've reached the voicemail of Hannah Brett with Connect Call, just leave a message and I'll get back to you soon as I can.
• 0:06
  [SPEAKER_00]: Thanks.
• 0:07
  [SPEAKER_00]: One for more options.
• 0:09
  [SPEAKER_01]: Hey Hannah, you don't know me, but I now know you because I've been tuning in to Connect Call I was on a flight recently, and I needed to download a podcast or two to get me through and thanks to Connect Call It got me through that flight.
• 0:25
  [SPEAKER_01]: I also didn't mean to sound corny, but I I digress anyway.
• 0:30
  [SPEAKER_01]: I really enjoyed Connect Call especially like the episode
• 0:35
  [SPEAKER_01]: On your depression, I really could connect and try to a lot of different treatments and anti-depressants and TMS, you name it that there's a lot of buzz around the psychedelics and what's going on with depression and PTSD and if you like it's still so taboo although I don't want to talk to you and I have a lot of questions.
• 0:58
  [SPEAKER_00]: Hi, this is Hannah Brett with another episode of Connect Call where I often say I do not have a clinical background, but I do have a PhD in picking up the phone for families and crisis, which many know I've done for like, I think, 20 years, including our guest Jonathan low aka what I used to call him at my old job jailo for those of you that, um,
• 1:20
  [SPEAKER_00]: It's seen this beautiful face before it's because he has been a guest on this show before and in the three months that we've been doing connect call there have been guests that have been requested back and you have been one of the chosen ones and so I'm just really happy to have Jonathan here.
• 1:38
  [SPEAKER_00]: a big reason and I always stress this and why I wanted to do connect call was not only to give these tangible resources and real time about real situations to families, but also really talk about the spectrum of treatment that is going on.
• 1:54
  [SPEAKER_00]: Working in the quote unquote treatment industry or the helping field, one of the frustrations I often find is a lot of times people
• 2:04
  [SPEAKER_00]: hate to say it, do not move with science.
• 2:07
  [SPEAKER_00]: And so because of that, you know, when it comes to mental health treatment or it comes to addiction treatment, we will find the the tried in through treatments that everyone feels safe with whether it's antidepressants, whether it's just talk therapy, all these different things, but you know, when we start,
• 2:25
  [SPEAKER_00]: talking about, which has been going on for years, by the way, a ketamine treatment, like we had discussed before, or now even more diving into the treatment of psychedelics for PTSD and trauma.
• 2:37
  [SPEAKER_00]: You know, a lot of people have a lot of opinions, but don't have a lot of information.
• 2:42
  [SPEAKER_00]: And that's why I wanted to bring Jonathan back on the show.
• 2:46
  [SPEAKER_00]: Um, personally professionally, um, I have also stressed this Jonathan and and welcome back.
• 2:52
  [SPEAKER_00]: Um, well, let me read your bio first.
• 2:55
  [SPEAKER_00]: It's very important for all the Jonathan Lowe is a doctor level psychiatric nurse practitioner graduating from the University of Pennsylvania.
• 3:04
  [SPEAKER_00]: 2007, he has completed advanced training through integrative psychiatric institute in the use of psychedelic medicines, including ketamine, and he currently works in North Lake Tahoe area, California, starting the areas first provoto clinic, which is amazing.
• 3:20
  [SPEAKER_00]: So Jonathan, thank you again for being here.
• 3:23
  [SPEAKER_00]: Um, there's no one better in my eyes that could really break all this down for viewers and listeners.
• 3:29
  [SPEAKER_00]: Um, and, and why, again, I stress why this is so important for me, especially personally, is someone who is really struggled with this treatment resistant depression I've always had.
• 3:41
  [SPEAKER_00]: I, you know, was someone who got sober old school, did the 12 steps.
• 3:46
  [SPEAKER_00]: Um,
• 3:47
  [SPEAKER_00]: And, you know, took my anti-depressants, but really was scared to try anything outside that box until, you know, it got to a point where this life I was building for myself wasn't really working because I wasn't open to the latest and greatest entreatment, right?
• 4:09
  [SPEAKER_00]: you know, it was, it was off to the races in a great way, you know, like I have said before the infusions of help me with ketamine with my depression, but now I'm really interested in more of what's going on with psychedelics.
• 4:21
  [SPEAKER_00]: And I guess just to start off, you know, when we hear the words psychedelic, what substances are we actually talking about?
• 4:29
  [SPEAKER_00]: What are people thinking we are talking about?
• 4:32
  [SPEAKER_00]: And what, by the way, are showing the most promise when we're talking about psychedelics for PTSD, trauma depression and anxiety?
• 4:40
  [SPEAKER_02]: Yeah, so psychedelics are, you know, kind of, I'll, I'll, I'll, I'll alter our state of consciousness, right?
• 4:47
  [SPEAKER_02]: Often leading to things like, you know, altered perceptions and reality, some psychedelics might produce a visual hallucinations, some psychedelics might produce auditory hallucinations.
• 5:00
  [SPEAKER_02]: many psychedelics will cause this dissociation kind of loss of physical self-sense of time and in particular doses, right?
• 5:10
  [SPEAKER_02]: This is all dose dependent.
• 5:13
  [SPEAKER_02]: And I think when most people hear the words psychedelic, I think that they think of more
• 5:20
  [SPEAKER_02]: Traditional psychedelics, a traditional psychedelics would be ones that are primarily focused on what are called 5HT-2A receptors, these are seroton receptors.
• 5:30
  [SPEAKER_02]: And when we activate, there's a lot of these receptor sites in visual centers of our brain, auditory centers of our brain.
• 5:37
  [SPEAKER_02]: So when we take large doses of these types of drugs, that's what kind of produces the flu synations that people have or the altered,
• 5:48
  [SPEAKER_02]: altered states of consciousness in those two specific areas, and examples might be psilocybin, or what people call magic mushrooms, DMT, which is a naturally occurring psychedelic, other naturally, or, you know, um,
• 6:04
  [SPEAKER_02]: naturally occurring psychedelics, whether it's eye-begin or mescaline, and then you have synthesized kind of in that same category of classic like LSD.
• 6:15
  [SPEAKER_02]: But I think most people think LSD and soul-scibe, and when I talk to them about psychedelics,
• 6:20
  [SPEAKER_02]: and then a broader right so that's that would be those would be classic and they would also be categorized as hallucinogens right and then for simple like just to simplify things you kind of have a category of hallucinogens you have empathics um which is mdma or what some people call x to c right on the street so you have mdma and then you have dissociatives and that's where ketamine and
• 6:50
  [SPEAKER_00]: So, just I'm going off script right now.
• 6:53
  [SPEAKER_00]: So when, cause here's where I find it really frustrating, and I've said this, I think, in the ketamine infusion episode, like colleagues that I work with are like, they're like, yo, how is your K-hole, you know, or when we start talking about treatment with psychedelics, they think you're gonna start tripping, or it's gonna be like acid, or like, you know, it's like the psychedelics we would take as kids at macro major,
• 7:18
  [SPEAKER_00]: levels to really do that, right, where we tripped or committed for long periods of time, you know, under the influence of.
• 7:26
  [SPEAKER_00]: And I guess what's been so maddening to me is maybe you can explain this better is the dosing of what we're talking about is so my mute.
• 7:36
  [SPEAKER_00]: And, you know, what, how, and maybe you can explain how scientists kind of figured out how the psychedelics were
• 7:48
  [SPEAKER_02]: Yeah, so if you're a psychedelic, yeah, so broadly speaking, like one of the benefits or a couple of the benefits of psychedelic medicine that we've seen in the brain is an increase in a neurotransmitter called glutamate, which is the number one restorative, reparative, excitatory neurotransmitter in our head, and if we can get that to activate, right?
• 8:10
  [SPEAKER_02]: If that speeds up new neuronal connections, strengthens axons and dendrites, kind of helps the brain to heal.
• 8:18
  [SPEAKER_02]: Oftentimes in severe depression, we see what's called cellular apoptosis or these areas of the brain where the neurons have kind of died, right, or they're not working anymore because they've been exhausted.
• 8:32
  [SPEAKER_02]: and getting that back right is important so that neuroplasticity is a big piece of all of these psychedelic treatments as well as is that kind of glutamate bursts that helps that along and then there's this other part of some psychedelics helping with what's called the default motor network, a default motor network in regions of the brain that are involved in like self reflection, rumination of thoughts,
• 9:01
  [SPEAKER_02]: Right?
• 9:01
  [SPEAKER_02]: And we've seen some remarkable improvements in that default motor network with psychedelics that again, we just haven't seen with traditional antidepressants.
• 9:13
  [SPEAKER_02]: Right.
• 9:14
  [SPEAKER_02]: There's always been a theory that many traditional antidepressants may not function for many patients the way we think that they are.
• 9:21
  [SPEAKER_02]: So for example, an SSRI, right, we're often told that
• 9:26
  [SPEAKER_02]: three to six weeks by a provider, you start this drug every day and you kind of have to wait.
• 9:31
  [SPEAKER_02]: And that waiting actually may be due to a downstream effect on glutamate.
• 9:36
  [SPEAKER_02]: It's, yes, it can be miserable.
• 9:38
  [SPEAKER_02]: Right.
• 9:39
  [SPEAKER_02]: And that, that.
• 9:41
  [SPEAKER_02]: that affect downstream actually may be involving glutamate, right?
• 9:47
  [SPEAKER_02]: Right.
• 9:48
  [SPEAKER_02]: Where, because if it was just pure serotonin reuptick and, you know, inhibiting the reuptick of serotonin, then we should see results within, you know, maybe even the first few doses.
• 9:58
  [SPEAKER_02]: And certainly there are some patients that I have that have that major shift or that turnaround after starting an answer to present.
• 10:05
  [SPEAKER_02]: But as we know, many patients, at least a third of patients,
• 10:10
  [SPEAKER_02]: will try multiple antidepressants and never achieve what we call response and a response meaning a 50% reduction in their symptoms is kind of the marker for success and once we have tried a couple of antidepressants and failed to respond to them, the likelihood that we're going to respond to any antidepressants tried after those first two is very, very
• 10:39
  [SPEAKER_02]: have options for patients, especially his category.
• 10:45
  [SPEAKER_00]: It's funny I was talking to a young adult male the other day.
• 10:48
  [SPEAKER_00]: who, again, he called me because his mother and I are friends.
• 10:53
  [SPEAKER_00]: He knows I don't have a clinical background.
• 10:56
  [SPEAKER_00]: I often say to anybody I speak to.
• 11:00
  [SPEAKER_00]: I believe my struggle has been real and hard a lot of times or has in the past so that I could hopefully answer questions so suffering wasn't as hard for others.
• 11:11
  [SPEAKER_00]: And I remember this is a young man who was tried a number of anti-depressants and he had questions about the ketamine infusions just because he was going to be assessed and he was really scared about how this whole process works.
• 11:25
  [SPEAKER_00]: And the one thing I did say to him is that again, this was my personal experience and I have also.
• 11:32
  [SPEAKER_00]: I under the guys of I have tried.
• 11:36
  [SPEAKER_00]: you know, the psilocybin trials and all of that.
• 11:39
  [SPEAKER_00]: And I will say the difference for me has been when I have sat in front of, um, you know, any psychiatrist or doctor who's describing me, my anti-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-dep-
• 11:52
  [SPEAKER_00]: depressive, depressive, they'll say, you know, in four to six weeks, we'll hopefully feel this shift, right?
• 11:58
  [SPEAKER_00]: And I'm like tracking my moods.
• 11:59
  [SPEAKER_00]: I'm like a really good patient.
• 12:01
  [SPEAKER_00]: I'll track my moods.
• 12:02
  [SPEAKER_00]: I'll do everything.
• 12:03
  [SPEAKER_00]: I'll even get some of those black box symptoms and try a different drug.
• 12:06
  [SPEAKER_00]: But I have yet to feel that shift typically.
• 12:10
  [SPEAKER_00]: I mean, it's very hard.
• 12:12
  [SPEAKER_00]: And so again, what I have found
• 12:17
  [SPEAKER_00]: And I stress this to this young man, I think in this is we're going to go into the next question about misconceptions.
• 12:22
  [SPEAKER_00]: I think this misconception that I'm, you know, is someone who has been sober for 23 years that I'm getting high, right?
• 12:29
  [SPEAKER_00]: And, and you know, I mean, and I'll say I'll get higher from a cigarette most of the time, you know, from actually even doing any of the
• 12:37
  [SPEAKER_00]: these treatments because there are such a small dose that and you know whether it's the infusion or when I've done a cellocybin trial or anything like that, you know, the dosing is so small that it's really not what people think it is.
• 12:50
  [SPEAKER_00]: And so why I again wanted to do an episode on this and talk about this more is also just for all those men and women out there who are in recovery, who are sober and there really isn't sometimes a place for us to talk about this stuff
• 13:07
  [SPEAKER_00]: Um, and, I mean, I know that Syllocybin is going to be the only the way the future is simply because I read the other day also, what is it, the pharmaceutical company, Lily, just like put down like $8.5 billion or something to buy the compound or something or the right to do.
• 13:24
  [SPEAKER_02]: Yeah, we're actually going to be seeing it's predicted.
• 13:27
  [SPEAKER_02]: We'll see, you know, these things can change really fast, right correct.
• 13:31
  [SPEAKER_02]: But the prediction is by the end of this year or certainly with during the 2027 year and probably first half.
• 13:40
  [SPEAKER_02]: We may see as many as four different psychedelics approved across a spectrum, a new form of ketamine approved, LSD approved, psilocybin approved and DNA approved, and now there's actually a new form of DNT that is also close to FDA approval, and a lot of that has to do with speeding up the process of, it doesn't mean that they're
• 14:05
  [SPEAKER_02]: they're going around or circumventing good science and good research.
• 14:09
  [SPEAKER_02]: Right.
• 14:10
  [SPEAKER_02]: It's just that the process is speeding up a little bit.
• 14:13
  [SPEAKER_02]: These drugs, of course, in our standard Western medicine way of studying and improving drugs are difficult to create studies for, because the gold standard is a placebo controlled trial.
• 14:25
  [SPEAKER_02]: And that's easy to do with something like Prozac, right?
• 14:28
  [SPEAKER_02]: Right.
• 14:29
  [SPEAKER_02]: But you kind of know if you're in the placebo group, if it's still a sign of it.
• 14:34
  [SPEAKER_02]: Right.
• 14:35
  [SPEAKER_02]: Yeah.
• 14:35
  [SPEAKER_02]: Yeah.
• 14:36
  [SPEAKER_02]: So it's hard to do a blind trial.
• 14:38
  [SPEAKER_02]: Right.
• 14:39
  [SPEAKER_02]: Patations with these drugs.
• 14:40
  [SPEAKER_00]: Right.
• 14:40
  [SPEAKER_00]: What are some of the biggest misconceptions you can think of about psychedelic assisted therapy that you're hearing there?
• 14:49
  [SPEAKER_02]: You know, I think...
• 14:51
  [SPEAKER_02]: And the biggest misconception are, you know, probably come from two groups of people.
• 14:57
  [SPEAKER_02]: One, groups of people that are familiar with these drugs in a recreational setting, right?
• 15:05
  [SPEAKER_02]: Right.
• 15:06
  [SPEAKER_02]: That's...
• 15:08
  [SPEAKER_02]: It, you know, you start talking about ketamine and, you know, they're kind of like eyes roll and like, oh, that's a party drug, right?
• 15:15
  [SPEAKER_02]: Right.
• 15:15
  [SPEAKER_02]: Or, you know, I've used ketamine and there's no way, you know, that it made me that I could see this as a treatment for depression, you're just getting people quote unquote high, right?
• 15:31
  [SPEAKER_02]: Right.
• 15:31
  [SPEAKER_02]: Which again is not to case, right, because when we think
• 15:36
  [SPEAKER_02]: how these drugs work, they're really just kind of a gateway.
• 15:40
  [SPEAKER_02]: It's not the drugs themselves, I tell patients that are the treatment, because if somebody needed to be on a steady bloodstream of ketamine or psilocybin or LSD, these medications wouldn't be functional, right?
• 15:53
  [SPEAKER_02]: The medications, it's all about creating a safe environment to administer the medicines at a very controlled dose.
• 16:01
  [SPEAKER_02]: And the real treatment actually comes after the medications have done their job and that glutamate bursts at neuroplasticity that those changes in the default motor network that I'm talking about like the real treatment comes after the experience.
• 16:19
  [SPEAKER_00]: Right.
• 16:20
  [SPEAKER_00]: No, and I think that's so important and just to like stress that too, you know, as
• 16:25
  [SPEAKER_00]: Uh, you know, someone who in my youth and before I got sober really abused stimulants and really abused alcohol, um, the last treatment you would think I would be up for, but my addiction therapist my Dictionologist therapist recommended for my wife and I when we were going through.
• 16:44
  [SPEAKER_00]: Some couples work where there was a lot of trauma was she was like, we're going to find somebody to help maybe do some MDMA do an intensive with you guys for a weekend, but also pulling in a psychedelic like MDMA because what it will allow you couldn't really get into all the science behind it, but what it will allow us to do was pull down those walls of trauma immediately pretty much.
• 17:05
  [SPEAKER_02]: So you're capable to do this work, and when I say that it's not because I'm rolling my face off, it's not what's going to happen, you know, no, no, you're you're working hard in sessions and it's not like you're, you know, on like a large amount of alcohol where you're saying things and you're not really in control and you're not remembering what happened, you were you were there, but the psychedelics just create a
• 17:32
  [SPEAKER_02]: a sense in the brain that it feels just so much safer to access these parts of ourselves because we bring down some of those emotional barriers and psychedelics are really good.
• 17:44
  [SPEAKER_02]: And this is another scary part, I think, for patients engaging in this therapy, it certainly was for me during our training, is that they will bring out what's called the shadow self in young and psychiatry, like these things that we just like push off into the shadows, right?
• 17:58
  [SPEAKER_02]: I don't want to think about this so what might emerge and I hear that a lot too from patients who have never experienced these substances is that they're concerned Well, what if I've repressed something since the age of five, and maybe I don't want to Maybe I don't want that brought up Maybe I don't want to bring that out.
• 18:14
  [SPEAKER_02]: I'm worried what might come up during the session
• 18:17
  [SPEAKER_00]: Well, I, you know, and I was working with some of these kids who survived some of these atrocious mass shootings in their schools and one or two of them, I know we're doing a study at Yale.
• 18:28
  [SPEAKER_00]: I think using psychedelics to really dive into some of the trauma stuff.
• 18:33
  [SPEAKER_00]: that they've most likely, you know, just push down.
• 18:38
  [SPEAKER_00]: I mean, it's interesting, I wish, in a way, you know, all the relatives that I had who survived the Holocaust and never dealt with that trauma.
• 18:45
  [SPEAKER_00]: I think of like what psychedelics could have done for them and they're healing and lives.
• 18:50
  [SPEAKER_00]: Because I just always think about, you know, on my aunts and how they just really were able to push all of that down their whole life, you know what I mean?
• 19:00
  [SPEAKER_02]: Yeah.
• 19:00
  [SPEAKER_02]: Like forced to push that down.
• 19:02
  [SPEAKER_02]: I think about that all the time.
• 19:03
  [SPEAKER_02]: I think about my own brother who died of an overdose and, you know, so many patients that I've lost in friends that I've lost along the way to substance abuse or suicide and man, you know, if I had a time machine.
• 19:22
  [SPEAKER_00]: Maybe things could have different totally I'm a very loud advocate of and I say this also people in the treatment field or anybody that is our naysayers is Walk in my shoes and let me know how that goes you know what I mean and and my belief is you know if I don't believe
• 19:41
  [SPEAKER_00]: and I only try to work with programs to where it's not this cookie cutter mold.
• 19:45
  [SPEAKER_00]: I don't believe that we are doing anything for any child or any adult.
• 19:50
  [SPEAKER_00]: If we are pushing a modality and medication, something that we just feel safe with, but isn't
• 19:56
  [SPEAKER_00]: isn't working, you know, and I do believe that more and more of these treatments are even going to be put into our, the treatment setting, you know, treatment more.
• 20:04
  [SPEAKER_00]: I know in mental health, they're definitely doing it, but, you know, I think even there's, there's more and more work around addiction, um, treatment using these medications.
• 20:13
  [SPEAKER_00]: And I think, you know, um, I guess it's like how those people used to be about antidepressants back on the day.
• 20:20
  [SPEAKER_00]: I think that's what's happening is people are just,
• 20:24
  [SPEAKER_02]: scared and judging.
• 20:25
  [SPEAKER_00]: But even, even our, and maybe you could tell us a little bit more about because I don't understand the eye-begining thing because I know President Trump is trying to push that forward with getting some clearance on that for troops and things like that of that trauma.
• 20:39
  [SPEAKER_00]: I don't know enough about eye-begining, but
• 20:42
  [SPEAKER_02]: Yeah, I beggine is like this wonderful can be wonderful, really challenging experience for many patients
• 20:57
  [SPEAKER_02]: It just because of the intensity and how prolonged it is and especially a lot of the physical symptoms that come up, there are quite often physical symptoms that come up with psychedelics and one of the interesting things is that we take a very different approach with these drugs and we do with traditional psychedelics, you know, if I place somebody on a
• 21:15
  [SPEAKER_02]: a typical prescription, you know, like say a prozacca is a loft and they're vomiting, right?
• 21:21
  [SPEAKER_02]: That scene is a negative side effect and we either try and treat the negative side effect with other drugs or remove the offending agent in these situations.
• 21:30
  [SPEAKER_02]: There, it's almost promoted to explore like what the body is trying to expel, so it's not seen as this.
• 21:37
  [SPEAKER_02]: this side effect that needs intervention, right?
• 21:40
  [SPEAKER_02]: That I need to, because you're vomiting, I need to step in and save you.
• 21:45
  [SPEAKER_02]: Like know that the body knows what it needs to do and I need to be there to support you.
• 21:49
  [SPEAKER_02]: I might have shared this with you last time, but the best way I can describe providing what it's like to provide therapy or care for these patients.
• 22:00
  [SPEAKER_02]: The closest thing that I experienced was my rotation in childbirth.
• 22:04
  [SPEAKER_02]: is that you're just letting and trying to let this natural process happen.
• 22:09
  [SPEAKER_02]: And you're really just there to support.
• 22:11
  [SPEAKER_02]: You're not there to intervene unless you have to.
• 22:15
  [SPEAKER_02]: But yeah, I began as another one of these.
• 22:18
  [SPEAKER_02]: psychoactive or psychedelic drugs that can provide all those benefits like we were talking about.
• 22:25
  [SPEAKER_02]: Right.
• 22:26
  [SPEAKER_00]: And then I guess in all different levels of psychedelic treatment like who would be a good candidate you would think for someone to start to explore psilocybin therapy or anything like that who would be a good candidate for you you think?
• 22:42
  [SPEAKER_02]: So when I think about, I think about psychedelic treatment versus psychedelic therapy.
• 22:47
  [SPEAKER_02]: Psychedelic treatment, right?
• 22:51
  [SPEAKER_02]: For me and my clinic, the folks that are going to fit that best, have to fit a pretty narrow diagnostic window right now.
• 23:00
  [SPEAKER_02]: In order to get FDA approval, because the medication is very expensive.
• 23:04
  [SPEAKER_02]: So they have to have severe treatment or resistant depression or major depressive disorder
• 23:11
  [SPEAKER_02]: And then I'm looking to rule out things like interstery, both hemorrhage, history of any, like aneurysmal, vascular diseases, things that would be problematic when we are taking some of these medications that will acutely raise both intercranial pressure and because blood pressure raises.
• 23:35
  [SPEAKER_02]: Also respiratory depression that can happen with things like ketamine and any preexisting breathing problems.
• 23:41
  [SPEAKER_02]: And then I'm looking out for things like bipolar one or schizophrenia.
• 23:46
  [SPEAKER_02]: Anything with like a psychotic kind of symptom attached to it.
• 23:51
  [SPEAKER_02]: Those are patients that we typically or will kind of avoid administering psychedelics too.
• 23:57
  [SPEAKER_02]: The bipolar 2 category is interesting because there was a lot of fear at first about treating folks with a label of bipolar 2, but now many of these drugs are looking for indications for bipolar 2 and what we're seeing overall is that these are safe for that population.
• 24:16
  [SPEAKER_00]: Okay, and then so that's that that's a good and I told Jonathan I may ask him a question about this just simply because and I will be talking about this on a new solo episode of mine as well as I'm very fortunate in the future I do to my own personal journey I got connected to what
• 24:34
  [SPEAKER_00]: This amazing woman named Dr. Carly Snyder, who's one of few reproductive psychiatrists in the world, really.
• 24:41
  [SPEAKER_00]: And she basically is a study of the reproductive cycle and all the mental health conditions that go with it.
• 24:46
  [SPEAKER_00]: And so why I say all this is like many of you out there who are probably a very strong opinion.
• 24:51
  [SPEAKER_00]: I my heart breaks for this whole Lindsey Clancy case story behind it.
• 24:57
  [SPEAKER_00]: hearing about how many providers she saw, how many medication she was put on, but as I'm talking to you, because I'm thinking, would psychedelics be something that could have been a help to this woman, you're saying if there's any chance of any sort of psychosis or that that wouldn't have been a good, she wouldn't have been a good possible candidate.
• 25:16
  [SPEAKER_02]: Yeah, no, I mean, like their folks that are psychotic with their depression.
• 25:21
  [SPEAKER_02]: And that's a different category.
• 25:23
  [SPEAKER_02]: Right.
• 25:23
  [SPEAKER_02]: So it's not necessarily that doesn't necessarily leave them out.
• 25:26
  [SPEAKER_02]: Postpartum depression is interesting.
• 25:28
  [SPEAKER_02]: You know, it might be a very close cousin to a bipolar illness.
• 25:32
  [SPEAKER_02]: That is kind of a brought on for even for the first time with some patients.
• 25:37
  [SPEAKER_02]: Because of these, these, all these hormonal shifts that are happening during pregnancy and birth and after, you know, and afterwards.
• 25:44
  [SPEAKER_02]: Right.
• 25:45
  [SPEAKER_02]: Right.
• 25:46
  [SPEAKER_02]: I don't know much about this case.
• 25:47
  [SPEAKER_02]: I have to be honest.
• 25:48
  [SPEAKER_02]: I think I've seen a couple of headlines because they're everywhere.
• 25:50
  [SPEAKER_02]: And so it's hard for me to kind of give an opinion.
• 25:54
  [SPEAKER_02]: I'd have to, you know, know more, but as far as psychedelics in general for postpartum depression.
• 26:00
  [SPEAKER_02]: Yeah, they are researching drugs like psilocybin and seeing enough promise to keep that research going.
• 26:06
  [SPEAKER_02]: Right.
• 26:07
  [SPEAKER_02]: If they work in the same manner as
• 26:13
  [SPEAKER_02]: the, you know, like for the population with tree resistant depression or major press disorder, then my expectation is that we would see a lot of success.
• 26:20
  [SPEAKER_02]: I kind of overall what we're seeing is about a 70% success rate or more with the populations that I'm speaking of.
• 26:27
  [SPEAKER_02]: And again, this is a population that would have about maybe a 12% 15% success rate if they continued on traditional oral antidepressants.
• 26:37
  [SPEAKER_02]: Right.
• 26:38
  [SPEAKER_02]: And so to get that jump, right, is, is, is massive.
• 26:41
  [SPEAKER_02]: It's, it's, it's life changing for so many of my patients.
• 26:44
  [SPEAKER_02]: Right.
• 26:44
  [SPEAKER_02]: And I hope that we see that with these other categories, not just postpartum depression, but eating disorders, right?
• 26:52
  [SPEAKER_02]: Substance use disorders, which we're looking for indications for a lot of these new psychedelics that can be very powerful and very helpful OCD on list kind of goes on and on.
• 27:03
  [SPEAKER_00]: And I think, and again, I know you don't know enough about the story, I think, why, without getting into all of it, what's kind of upsetting, upsetting, it's very tragic.
• 27:12
  [SPEAKER_00]: It was about a woman who was never diagnosed for any sort of postpartum whatsoever, and she actually did struggle with postpartum psychosis, and unfortunately killed all three of her children.
• 27:23
  [SPEAKER_00]: And I think, well,
• 27:25
  [SPEAKER_00]: as a patient is also a professional, the most frustrating thing I have still found in mental health, just like I guess physical health too, is for me to, and we can talk about this, for me to access or even get a conversation going about ketamine treatment or psychedelic treatment, I have to be the one discussing and bringing this up to my prescriber most of the time, and with that, there sometimes can be shame involved.
• 27:53
  [SPEAKER_00]: And, you know, or they don't have enough, it's kind of like, and I hate saying this is like, I went to a million gynecologists before, you know, I found one who actually understood that, you know, we're going to treat you and not the number and that you're not crazy.
• 28:07
  [SPEAKER_00]: You're just going through some, you know, your sensitive
• 28:12
  [SPEAKER_00]: you know, but most most I think I think what would help to with mental health care, physical hair, but definitely mental health care, if there was a constant retraining of these professionals, you know, so they're aware of the benefits of of these types of medicine and that it shouldn't take your patient having to inquire about it for it to be discussed.
• 28:38
  [SPEAKER_02]: Yeah, and there's going to be a lot of, I think, lag time between, as there is with any medication, but I think it's especially a longer lag time with the psychedelic treatments, just to, to maybe inherent bias from providers that are licensed to prescribe these medications and knowing that probably the most, like the target audience that is seeking this information out,
• 29:03
  [SPEAKER_02]: is mostly going to be in the, you know, psychiatry, realm, therapy realm, and but our number one prescribers of antidepressants are primary care providers, and the other thing too is that the way that these medicines are being set up and the safeguards is that they're going to require a lot of time and space from that provider.
• 29:27
  [SPEAKER_02]: to administer and monitor patients who are taking these medications in the office and our current medical offices aren't set up for that type of care.
• 29:37
  [SPEAKER_02]: They're set up for quick turnaround, one patient at a time, not spending hours with a patient or with patients in a group treatment setting.
• 29:48
  [SPEAKER_02]: And then we have the problem with reimbursement is getting our insurance companies to understand this bill.
• 29:57
  [SPEAKER_02]: How do we bill?
• 30:00
  [SPEAKER_02]: If my time is being used for eight hours with some of these medications, how is that feasible financially for the patient and the provider?
• 30:11
  [SPEAKER_00]: I think I'm not expecting these providers to actually do it themselves.
• 30:14
  [SPEAKER_00]: I think what would be really great is they if they were educated about this to also start the conversation, but then had trusted providers they could refer to and happily do that.
• 30:26
  [SPEAKER_00]: Yes.
• 30:27
  [SPEAKER_00]: And recognize that
• 30:30
  [SPEAKER_00]: this way isn't working.
• 30:31
  [SPEAKER_00]: You know, as I say to, um, and this is just how I feel, but, you know, you know, like I was talking to this young man the other day who said I he was scared about doing this infusion and I go, for me what's scarier and I got a be honest was always trying a new antidepressant because I was so sensitive that when I would try one that was bad,
• 30:57
  [SPEAKER_00]: You know, right had all these horrible, horrible symptoms right out the gate and that to me was scarier or having to there was a period of my life where I was literally all these prescribers were just bouncing one antidepressant after the next and my system in a very short period of time that was scary to me, you know, I think.
• 31:19
  [SPEAKER_00]: I think, or, you know, being a candidate for electric shock therapy, that was kind of scary.
• 31:24
  [SPEAKER_00]: You know, so I feel like I think, um, these are exciting times, ladies and gentlemen.
• 31:31
  [SPEAKER_00]: I think, you know, I think where we are today was science.
• 31:35
  [SPEAKER_00]: And I feel that, unfortunately, I wish we had other people in office who were on board with this kind of stuff, but I really feel that somebody
• 31:45
  [SPEAKER_00]: has struggled, especially when you were asking someone to wait those four to six weeks with anything, it's a really, really, really long time, especially when you're suffering, you know?
• 31:56
  [SPEAKER_00]: Yes, correct.
• 31:58
  [SPEAKER_00]: And can you just explain, though, it's like a delicate assisted therapy or treatment, sorry, treatment.
• 32:03
  [SPEAKER_00]: And you compare to ketamine treatment, like when I do my
• 32:09
  [SPEAKER_00]: When I am done, maybe 45 minutes later, I am back at work.
• 32:11
  [SPEAKER_00]: I cannot drive, but I am back at work.
• 32:14
  [SPEAKER_00]: Clear is can be.
• 32:17
  [SPEAKER_00]: What are you notice any differences between the treatment?
• 32:21
  [SPEAKER_00]: If there are any.
• 32:23
  [SPEAKER_00]: Like the difference like a deluxe?
• 32:25
  [SPEAKER_00]: Well, just between, yeah, we said, ketamine is a psychedelic, right?
• 32:29
  [SPEAKER_02]: Yeah, and it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it's, it
• 32:47
  [SPEAKER_02]: mushroom strength, mushroom strain, because they can be very different in terms of their potency, right?
• 32:52
  [SPEAKER_02]: But when we're talking about that type of treatment, you're looking at sometimes as little as four, sometimes as much as eight hours of needing to be held in a safe container.
• 33:03
  [SPEAKER_02]: And afterwards,
• 33:06
  [SPEAKER_02]: You know, I have not met a patient who felt like, you know, ready to go back to work.
• 33:11
  [SPEAKER_02]: They definitely needed the rest of the day at least.
• 33:14
  [SPEAKER_02]: And that's what we're talking about doing the journey.
• 33:16
  [SPEAKER_00]: I'm not fast towards.
• 33:18
  [SPEAKER_02]: Correct.
• 33:18
  [SPEAKER_02]: Right.
• 33:18
  [SPEAKER_02]: Yeah.
• 33:20
  [SPEAKER_02]: Often meeting up the following day just to integrate the experience that happened to the previous day with the medication.
• 33:27
  [SPEAKER_02]: with ketamine, yeah, most of my patients with the internal nasal form of this ketamine, which is really more psychedelic, you know, like it's not full psychedelic.
• 33:35
  [SPEAKER_02]: Do patients have profound experiences?
• 33:39
  [SPEAKER_02]: Absolutely, right?
• 33:41
  [SPEAKER_02]: Um, but,
• 33:43
  [SPEAKER_02]: Without medication, most of my patients feel fully recovered and like ready to go at the 90 minute mark.
• 33:49
  [SPEAKER_02]: They have to be under my observation for two hours, at least.
• 33:53
  [SPEAKER_02]: Right, minimum.
• 33:55
  [SPEAKER_02]: But yeah, many of my patients do go back to work as long as their work doesn't involve heavy machinery or a tremendous, like I'm not sending my surgeons back into the operating room after treatment.
• 34:07
  [SPEAKER_02]: Right.
• 34:09
  [SPEAKER_02]: Even though they feel fine, right?
• 34:11
  [SPEAKER_02]: And the nice thing too is that when we're talking about side effects or negative experiences, you're not talking, you mean you're talking a matter of hours.
• 34:18
  [SPEAKER_02]: These, especially with ketamine, it's kind of in and out of your system very much.
• 34:24
  [SPEAKER_02]: And the, the dosing control, right?
• 34:25
  [SPEAKER_02]: No one is ever going to end up in a k-hole or having those really negative experiences.
• 34:30
  [SPEAKER_02]: No ketamine.
• 34:31
  [SPEAKER_02]: If it's being dosed in a, and administered in a, the proper setting, right?
• 34:37
  [SPEAKER_02]: It's just not, it's just not possible.
• 34:39
  [SPEAKER_02]: Right.
• 34:40
  [SPEAKER_02]: The the IV is nice because it's so controllable.
• 34:44
  [SPEAKER_02]: Right.
• 34:44
  [SPEAKER_02]: Whereas, you know, forms like an intermuscular, you know, you kind of it's like jumping into the deep end of the pool like I'm going to put this dose in you and I just no takebacks.
• 34:55
  [SPEAKER_02]: And for some patients that works and for some patients that control the IV or being able to add in like anti-naj or medicine or anti-anxiety medicines while the ketamine is going in or the experiences happening can be really really helpful.
• 35:11
  [SPEAKER_02]: And then of course, the S ketamine that I'm using is intranasal and and there was
• 35:18
  [SPEAKER_02]: You know, like in terms of like like the the experience there's this little rhyme that's used in the psychedelic space where it says If I remember correctly, ketamine is like a trip to space, uh, psilocybin is a punch in the face and MDMA is a warm embrace.
• 35:48
  [SPEAKER_00]: I mean, I, I was saying to Becky Gedulele the other day on the pot, my podcast that I wanted my merch line to be whoever has the peso says the say so, but I hear that's taken, so I think I'm going to replace it with that.
• 36:00
  [SPEAKER_00]: I guess I get, and my big question, too, is I think with everybody listening and wanting to be a resource for everybody is.
• 36:08
  [SPEAKER_00]: If, like, I feel that, you know, you can go online, you can, when looking for Spurvato or ketamine infusions, there's plenty of websites out there.
• 36:19
  [SPEAKER_00]: You're looking for people, you know, the about page where there are medical professionals administering this in a safe environment.
• 36:25
  [SPEAKER_00]: That's pretty accessible, I find.
• 36:28
  [SPEAKER_00]: When, if there's people out there looking to,
• 36:31
  [SPEAKER_00]: want to look into psilocybin or other psychedelics, can you give them any recommendations of where to go to safely be able to find this treatment?
• 36:42
  [SPEAKER_02]: Yeah, there's a couple of hubs that I think of off the top of my head, not for finding locating treatment centers, this first one exactly, but when it comes to just kind of an understanding of what's happening in a psychedelic realm,
• 37:02
  [SPEAKER_02]: And they have a wonderful bullseye chart that will show everybody kind of where in the pipeline and one indication are these medications.
• 37:12
  [SPEAKER_02]: How close are they to FDA approval right now right.
• 37:16
  [SPEAKER_02]: Because they're, so for psilocybin, right, we have legal clinical use in Oregon and Colorado, but they're still not, it's still not FDA legal, almost a, I mean, same thing like with cannabis, where it's legal for even recreational purposes in some states, but that started off with medical use and medical cards, right?
• 37:37
  [SPEAKER_02]: But it's as far as,
• 37:41
  [SPEAKER_02]: You know, other, you know, other good sites, just for general knowledge, another one that I like is a spirit pharmacist.
• 37:48
  [SPEAKER_02]: It's a run by a pharmacist with a deep understanding and wonderful accessible information for patients to understand how their medications might need to be altered if at all because there's a lot of misconceptions out there about what can and can't be taken with the second notes.
• 38:12
  [SPEAKER_02]: As far as a treatment, like accessible treatment, you know, folks like the wounded warriors project that have been around a long time and are still having to kind of plan trips outside of the country, Costa Rica, just had a patient come back from Costa Rica for an eye-begining experience, but that's a huge cost, right?
• 38:33
  [SPEAKER_02]: One thing to look for is you are trying to explore
• 38:39
  [SPEAKER_02]: the one loophole that exists are seminaries, you know, church groups, right?
• 38:47
  [SPEAKER_02]: Organizations that have formed to get around the FDA, kind of blockade of psilocybin.
• 38:56
  [SPEAKER_02]: And many of us probably have these near or even in our communities and don't even know it.
• 39:01
  [SPEAKER_02]: And these will be organizations that form a nonprofit, you know,
• 39:08
  [SPEAKER_02]: virtual religious organization and then a part of their practice is to use psilocybin in ceremony.
• 39:14
  [SPEAKER_02]: And so then they're able to provide these services or these medicines.
• 39:20
  [SPEAKER_02]: But then of course can't call it medicine.
• 39:22
  [SPEAKER_02]: They can't call it treatment.
• 39:23
  [SPEAKER_02]: They're not going to diagnose you.
• 39:24
  [SPEAKER_02]: So you're still working either with a therapist or a medical provider that understands these things.
• 39:30
  [SPEAKER_02]: But they do give us, I think, a safer pathway to access things like people are working with
• 39:36
  [SPEAKER_00]: to be.
• 39:39
  [SPEAKER_02]: Yeah, or like there's also like near us in Nevada.
• 39:44
  [SPEAKER_02]: There are sometimes you can find certain tribes and on reservation tribal land where they will provide the service.
• 39:53
  [SPEAKER_02]: Some do some don't to outsiders, right?
• 39:55
  [SPEAKER_02]: Um, very.
• 39:57
  [SPEAKER_02]: And, you know, so there are, there are ways, right?
• 40:01
  [SPEAKER_02]: But if for somebody who's just looking to start to explore this round, the reason I like the exploration to start with ketamine is again, it can be so controlled, if you meet criteria, approved by insurance.
• 40:16
  [SPEAKER_02]: So, you might as well.
• 40:17
  [SPEAKER_02]: My Medicaid patients pay $0 for their treatment.
• 40:20
  [SPEAKER_00]: I'm covered for the infusions.
• 40:22
  [SPEAKER_00]: I don't have to pay.
• 40:23
  [SPEAKER_00]: So, that's awesome.
• 40:24
  [SPEAKER_00]: Yeah, right.
• 40:25
  [SPEAKER_00]: And so, too.
• 40:26
  [SPEAKER_02]: Yeah, go you.
• 40:27
  [SPEAKER_02]: Right.
• 40:28
  [SPEAKER_00]: Let's go.
• 40:29
  [SPEAKER_02]: Woo!
• 40:29
  [SPEAKER_00]: Treatment is different.
• 40:31
  [SPEAKER_00]: I have to try a million meds and you get a permit.
• 40:32
  [SPEAKER_00]: Yeah.
• 40:33
  [SPEAKER_02]: And you get a permit.
• 40:35
  [SPEAKER_02]: And so, and because of the short length of time, I think it's a good introduction.
• 40:40
  [SPEAKER_02]: It is a very different experience, of course, to something like psilocybin or traditional psychedelics, but at least can give patients a way to kind of
• 40:52
  [SPEAKER_02]: Comfortably enter the dip their toe in if you dip their toe in and again with a drum that is just so safe I mean ketamine is a medication that we give to you know infants when we can't give them Tylenol Right, um, this is a medication that is again just proven time and time and again to be safe where it gets a bad rap is when people
• 41:15
  [SPEAKER_02]: are abusing it.
• 41:16
  [SPEAKER_02]: I mean, you could abuse anything, right?
• 41:18
  [SPEAKER_02]: Thank you.
• 41:18
  [SPEAKER_02]: That's what I said.
• 41:20
  [SPEAKER_00]: One that whole story, which was really tragic about Matthew Perry came out.
• 41:24
  [SPEAKER_00]: I remember my initial reaction was shit, part of my French, but I was like shit.
• 41:31
  [SPEAKER_00]: Now, everyone's going to like say, told you still with the ketamine and dead it at it.
• 41:35
  [SPEAKER_00]: And my thing was, you know, and I immediately said, yeah, and Michael Jackson abuse profile, but we're still using it for surgery, like if used, under the, you know, and anybody can abuse anything.
• 41:46
  [SPEAKER_00]: Unfortunately, when you have that much power and money, you can find the right doctor that's going to give you vials and vials of ketamine.
• 41:52
  [SPEAKER_00]: And that's what happened to him, you know, and I mean, and he wasn't being he wasn't under a doctor supervision, no.
• 41:59
  [SPEAKER_02]: It was under any supervision, you know, it was under what's alone in a hot tub.
• 42:03
  [SPEAKER_02]: Yeah, but it's assisted and walked away, you know, it was, yeah, it was tragic.
• 42:08
  [SPEAKER_00]: But again, anything can be abused and my whole thing is I still think alcohol is one of the most dangerous things out there.
• 42:16
  [SPEAKER_02]: Imagine if we were trying to get FDA approval for alcohol like starting to do it.
• 42:20
  [SPEAKER_02]: We're like, hey, listen, we've got this drug.
• 42:22
  [SPEAKER_02]: It makes you black out.
• 42:23
  [SPEAKER_02]: It makes you not able to drive.
• 42:25
  [SPEAKER_02]: It makes you angry.
• 42:26
  [SPEAKER_02]: It has no medicinal purposes.
• 42:28
  [SPEAKER_02]: It's a depressant.
• 42:30
  [SPEAKER_02]: And if you're physically addicted, what do you think?
• 42:32
  [SPEAKER_02]: Well, kill you if you just stop.
• 42:34
  [SPEAKER_00]: Yeah, sure.
• 42:34
  [SPEAKER_00]: But yeah, but go for it.
• 42:37
  [SPEAKER_00]: That's great.
• 42:38
  [SPEAKER_00]: Where do you see psychedelic medicine in the next five to 10 years?
• 42:43
  [SPEAKER_02]: mean hopefully on the same track that we're seeing now where we just have more and more options come out as these options come out we continue to monitor them very closely just to ensure you know safety and that the public feels comfortable and then just increasing access because like I live in a really rural community in North Lake Tahoe, right?
• 43:06
  [SPEAKER_02]: And
• 43:08
  [SPEAKER_02]: You know, so for environments like mine where you don't have a high population, right, and maybe your closest city is going to be Reno or Sacramento, that could be a huge barrier to care.
• 43:19
  [SPEAKER_02]: But as we gather more safety data on these medications.
• 43:24
  [SPEAKER_02]: you know, hopefully allowing safe at home treatment for patients or the right patients, right?
• 43:30
  [SPEAKER_02]: Um, and so yeah, my hope is over the next 10 years that that we see increased access, right?
• 43:38
  [SPEAKER_02]: Um, de-sitivating, affordability and then the other piece is just also understanding them beyond
• 43:50
  [SPEAKER_02]: the waiting for the diagnosis to get so bad.
• 43:53
  [SPEAKER_02]: So why can't we use these first line?
• 43:55
  [SPEAKER_02]: Right?
• 43:56
  [SPEAKER_02]: Why do we have to go through and they will the trials if we know that this stuff works?
• 44:03
  [SPEAKER_00]: I know, I mean, I'm just, I put my shit out there, Jonathan, I was just on the phone with my insurance company before because the anti-depressant that I was originally put on a couple years ago.
• 44:14
  [SPEAKER_00]: They switched it.
• 44:15
  [SPEAKER_00]: My insurance wasn't paying for it.
• 44:18
  [SPEAKER_00]: It was a newer drug.
• 44:19
  [SPEAKER_00]: And so we did the compounded version of right.
• 44:21
  [SPEAKER_00]: And so finally my doctors like, let's try your insurance company again and see they'll pay for it.
• 44:25
  [SPEAKER_00]: And again, in their speech, they're like, well, did you try and fail six other anti-depressants first.
• 44:32
  [SPEAKER_00]: And like why do we need to go there like why do we need to be so many because people are just suffering.
• 44:39
  [SPEAKER_02]: Well, there's some free and easy life threatening illnesses and you know, like I want the same respect, not that other areas of medicine do much better like there's all but I don't think we should be having.
• 44:50
  [SPEAKER_02]: Right, the extent that we have to struggle with these symptoms in mental health and the length of time that we need to fail, which is sometimes months or years would be an absolute, like it would be ridiculous in other areas of medicine.
• 45:06
  [SPEAKER_00]: Or I was told by insurance companies in the past you weren't depressed enough like who tells me like and I'm writing back to that insurance company going that's like me breaking my ankle and you're saying well you didn't really break it enough right you got a you know a little bit more it's absolutely craziness you know when I I always preach that if we're going to talk about the war on mental health the first thing we need to do is work on those insurance companies.
• 45:29
  [SPEAKER_00]: Last but not least, Jonathan Low, if you are talking to somebody on the phone, a candidate for psychedelic treatment, what would be some last parting words you would like to give them that you would like them to hear if there is some fear or resistance to doing something like this.
• 45:47
  [SPEAKER_02]: Well, first I always say that the fear and resistance is normal, like even for myself and my psychedelic training, a part of the psychedelic training community promotes not just learning how to provide the care, but being the patient as well.
• 46:01
  [SPEAKER_02]: And I felt so uncomfortable.
• 46:02
  [SPEAKER_02]: both that.
• 46:03
  [SPEAKER_02]: It took the months and months of talking it out to try and wrap my head around why I needed to take these medicines, why I need to take the drugs.
• 46:14
  [SPEAKER_02]: And so know that that fear and that resistance is normal and part of it has to do just how your brain works.
• 46:21
  [SPEAKER_02]: It our brains on a neurological level don't really care about our happiness.
• 46:27
  [SPEAKER_02]: It cares about survival, and some of us have been surviving with depression for a very long time.
• 46:32
  [SPEAKER_02]: And so walking into a therapist's office, trying any new medication, my expectation is that there's automatic resistance from the brain, because basically you have a brain that says, hey, being as depressed as we are, or a hundred percent survival rates.
• 46:47
  [SPEAKER_02]: And now you're trying to mess with a hundred percent survival rates, even though logically you know you don't like the way you
• 46:55
  [SPEAKER_02]: And so it's just understanding that you are not depressed, right?
• 46:59
  [SPEAKER_02]: Your brain is depressed.
• 47:00
  [SPEAKER_02]: The organ is depressed.
• 47:02
  [SPEAKER_02]: You are not.
• 47:03
  [SPEAKER_02]: You don't have depression, right?
• 47:05
  [SPEAKER_02]: Your brain has the symptom.
• 47:08
  [SPEAKER_02]: I'm always careful to help my patients not to identify with their mental illnesses, because we don't do that with any other organ illness.
• 47:15
  [SPEAKER_02]: We don't walk into our mothers' office or say, you know, I am stomachache, I am broken ankle, I am,
• 47:21
  [SPEAKER_02]: You know, whatever.
• 47:22
  [SPEAKER_02]: We don't say that, but we all the time we say I am anxious.
• 47:26
  [SPEAKER_02]: I am depressed.
• 47:27
  [SPEAKER_02]: That's just an organ.
• 47:29
  [SPEAKER_02]: Right.
• 47:29
  [SPEAKER_02]: And the resistance comes from that without even dropping knowledge, right?
• 47:34
  [SPEAKER_02]: It's just that organ trying to protect you in the ways that it knows how and it only knows that you're alive today based on all of your experiences, which is why these changes is so hard to make.
• 47:44
  [SPEAKER_02]: And then sitting with a provider, again, just making sure that they take the time and that they're not pressuring you, right, that they're pointing you in the right direction, giving you the education you feel you need, but also at the same time, challenging your depression, right, I don't want to see my patients depression, making the decision not to engage in treatment, I want to challenge that just same thing with addiction, right, I don't want to let my patients addicted disorder make the decisions for them because I don't think it's making good decisions on their behalf.
• 48:13
  [SPEAKER_02]: I trust my patients.
• 48:15
  [SPEAKER_02]: I don't trust their addiction.
• 48:16
  [SPEAKER_02]: I trust my patients.
• 48:17
  [SPEAKER_02]: I don't trust their depression.
• 48:19
  [SPEAKER_02]: Right.
• 48:20
  [SPEAKER_02]: And helping them to kind of separate consciously from from that process.
• 48:25
  [SPEAKER_02]: And then, you know, so yeah, it's normal to go in with skepticism, hesitancy.
• 48:31
  [SPEAKER_02]: Especially after we've been burned so many times if we are a treatment resistant patient.
• 48:37
  [SPEAKER_02]: you're not walking in, hopeful, right?
• 48:39
  [SPEAKER_02]: Like, hey, I've tried all the things I've been told to try and nothing's worked with what why this, right?
• 48:45
  [SPEAKER_00]: Don't be like me who just believed all the like.
• 48:49
  [SPEAKER_00]: I believed my fear about the ketamine cells.
• 48:52
  [SPEAKER_00]: Like, yeah, I'm going to do ECT first.
• 48:53
  [SPEAKER_00]: Let's try that bad boy, you know, because I thought that was the safety or easier route.
• 48:57
  [SPEAKER_00]: Not saying it's bad for some people.
• 48:58
  [SPEAKER_00]: Some people, times it's very effective.
• 49:01
  [SPEAKER_00]: But I encourage people before they are just so quick to say no is to do your due diligence.
• 49:07
  [SPEAKER_00]: And really, you know, read about and study or look up, you know, some of these treatments before because a lot of times when I do get this like false narrative coming back at me about all this stuff,
• 49:19
  [SPEAKER_00]: based on nothing but their fear, like, nothing, nobody's, you know what I mean?
• 49:23
  [SPEAKER_00]: So I do encourage that, because I do see how psychedelics are saving people's lives today.
• 49:29
  [SPEAKER_00]: And really, yeah, I'm for it.
• 49:31
  [SPEAKER_02]: Yeah, I'm on the flip side, you know, working with people that aren't just all gung-ho and positive about it, too, right?
• 49:36
  [SPEAKER_02]: Like, you want a provider that is telling you, here's the, you know, the, what we know, that's good, and here's what we know that could potentially be negative, right?
• 49:44
  [SPEAKER_02]: It shouldn't all be like, you know, just like almost evangelical selling of psychedelics, right?
• 49:51
  [SPEAKER_02]: No, he's medic, and like for my substance use population, I often will refer them to online psychedelics and recovery groups, which are growing in number.
• 50:02
  [SPEAKER_02]: So an alternative to maybe their AA or NA space to help them be in an environment that is comfortable and supportive so they can at least ask the questions and feel comfortable asking the questions.
• 50:14
  [SPEAKER_02]: Right.
• 50:15
  [SPEAKER_00]: Because I did.
• 50:16
  [SPEAKER_00]: I first started learning about psychedelics from men and women who had like over 30 years of sobriety and it was just like on the dial.
• 50:23
  [SPEAKER_00]: They just don't talk about it.
• 50:25
  [SPEAKER_00]: You know, we're not supposed to talk about it.
• 50:27
  [SPEAKER_00]: And so there's this like, you're already feeling the shame already.
• 50:30
  [SPEAKER_00]: And then you're told not to talk about it.
• 50:31
  [SPEAKER_00]: So that's really great information too.
• 50:34
  [SPEAKER_00]: And again, Jonathan, I'm just again so grateful that you came back on the show.
• 50:38
  [SPEAKER_00]: You are going to be probably a repeat offender here on Connect Call.
• 50:43
  [SPEAKER_00]: I hope of you are a wealth of knowledge.
• 50:47
  [SPEAKER_00]: And I really appreciate you.
• 50:49
  [SPEAKER_00]: This is another episode of Connect Call.
• 50:51
  [SPEAKER_00]: Please tune in every week on Thursday, make sure you go to your Spotify, Apple Podcasts and YouTube to subscribe and check us out and we look forward to another episode coming soon.
• 51:02
  [SPEAKER_00]: Thank you.
• 51:02
  [SPEAKER_00]: Thank you for tuning into this episode of Connect Call.
• 51:05
  [SPEAKER_00]: As we conclude, remember that insights shared are intended for information on educational purposes only and should not substitute professional medical advice, diagnosis or treatment.
• 51:15
  [SPEAKER_00]: We strongly recommend consulting a qualified medical health professional or health care provider for personalized advice tailored to your unique needs.
• 51:24
  [SPEAKER_00]: your mental health journey is important and having the right support is essential.
• 51:28
  [SPEAKER_00]: If you're experiencing a mental health crisis or require immediate assistance, please reach out to a mental health provider or emergency services in your area.
• 51:37
  [SPEAKER_00]: We're grateful to have you as part of our community and your well-being remains our priority.
• 51:42
  [SPEAKER_00]: So follow us on social media to stay connected and be sure to catch one of our episodes on our YouTube channel.
• 51:48
  [SPEAKER_00]: We're here to support you every step of the way.